Intergrating a Smoke-Free Home Intervention into the 5As to Support Cessation

将无烟家庭干预纳入 5A 以支持戒烟

• 批准号: 10442550
• 负责人: MICHELLE C KEGLER
• 金额: $ 64.49万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-04 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10442550
• 关键词: Address; Adoption; Advisory Committees; Alabama; Child; Communities; Data; Data Pooling; Environment; Evaluation Research; Federally Qualified Health Center; Florida; Home; Home environment; Household; Intervention; Intervention Studies; Low Income Population; Low income; Mind; Modeling; Ohio; Oklahoma; Outcome; Participant; Patients; Pharmacotherapy; Phase; Population; Population Analysis; Positioning Attribute; Prevention Research; Preventive service; Primary Health Care; Process; Provider; Randomized Controlled Trials; Reporting; Research; Rural; Rural Population; Site; Smoke; Smoke-free home; Smoker; Smoking; Testing; Time; Tobacco Control Research; Tobacco Use Cessation; Vulnerable Populations; cigarette smoke; cost; dissemination trial; effectiveness trial; efficacy testing; efficacy trial; environmental tobacco smoke exposure; follow-up; implementation evaluation; implementation outcomes; innovation; novel strategies; patient oriented; patient population; patient subsets; primary care setting; process evaluation; quitline; reduce tobacco use; safety net; service delivery; smoking cessation; smoking cue; social; socioeconomic disadvantage; treatment as usual

SUMMARY Establishing smoke-free homes may be a promising approach to support, and perhaps catalyze, smoking cessation. The inconvenience of going outside, combined with a reduction of environmental cues to smoke in the home, may result in less smoking and increased efforts to quit. Yet, no rigorous studies have tested the impact of creating smoke-free homes on cessation outside the context of protecting children from secondhand smoke exposure. We have developed a brief smoke-free homes intervention, “Some Things are Better Outside”, that is very effective in promoting the adoption of total smoking bans in low-income households. As part of NCI’s State and Community Tobacco Control research initiative, we conducted an efficacy trial, an effectiveness trial, a generalizability trial and a dissemination trial with positive outcomes in each phase of the research. Pooled data from our three RCTs, combined with results from a national dissemination study, document the potential of the intervention to support cessation. We propose to partner with two large federally qualified health centers (FQHCs) in rural south Georgia to rigorously test the efficacy and potential scalability of integrating a smoke-free homes intervention into the 5A (Ask, Advise, Assess, Assist, Arrange) approach for tobacco cessation recommended by the U.S. Preventive Services Task Force. FQHCs serve as the safety net of primary care for vulnerable populations in the U.S. Most FQHC patients are socioeconomically disadvantaged and represent a high priority for cessation. Developing and testing an approach for integrating the intervention into FQHCs from the outset should increase potential use of the intervention if proven effective. Our first aim is to adapt the intervention for integration into the 5As for tobacco cessation, followed by an RCT to test the efficacy of integrating the smoke-free homes intervention into the 5A approach for smoking cessation among FQHC patients. This approach may have broader reach than current approaches as it may appeal to those not yet ready to quit, as well as provide a social and physical personal environment that supports increased quit attempts and successful cessation. We also plan to conduct a multi-component process evaluation that examines implementation outcomes, cost and scalability potential. The proposed research will be the first to rigorously assess whether the integration of a strong smoke-free homes intervention into the 5As can encourage sustained smoking cessation in low-income patients.

概括 建立无烟之家可能是支持甚至促进吸烟的一种有前途的方法 停止。外出不便，​​加上室内吸烟的环境因素减少 在家中，可能会减少吸烟并加大戒烟力度。然而，还没有严格的研究测试过 在保护儿童免受二手烟危害的背景下创建无烟家庭对戒烟的影响 烟雾暴露。我们制定了一项简短的无烟家庭干预措施，“有些事情会更好 外面”，这对于促进低收入家庭全面禁烟非常有效。 作为 NCI 州和社区烟草控制研究计划的一部分，我们进行了一项功效试验， 有效性试验、普遍性试验和传播试验在每个阶段都取得了积极成果 研究。汇总我们三个随机对照试验的数据，结合全国传播研究的结果， 记录支持戒烟的干预措施的潜力。我们建议与两个大型联邦机构合作 乔治亚州南部农村地区的合格医疗中心 (FQHC) 严格测试其功效和潜在的可扩展性 将无烟家庭干预纳入 5A（询问、建议、评估、协助、安排）方法 美国预防服务工作组建议戒烟。 FQHC 充当安全网 大多数 FQHC 患者的社会经济状况 处于不利地位，并成为戒烟的高度优先事项。开发和测试集成方法 如果得到证实，从一开始就对 FQHC 进行干预应该会增加干预措施的潜在用途 有效的。我们的首要目标是调整干预措施以纳入戒烟 5A，然后是 一项随机对照试验，测试将无烟家庭干预纳入 5A 吸烟方法的有效性 FQHC 患者中的戒烟。这种方法可能比当前方法具有更广泛的影响，因为它可能 吸引那些尚未准备好戒烟的人，并提供一个社交和物质的个人环境， 支持增加戒烟尝试和成功戒烟。我们还计划开展多方面的活动 流程评估，检查实施结果、成本和可扩展性潜力。拟议的 研究将首先严格评估是否整合强有力的无烟家庭干预措施 纳入 5A 可以鼓励低收入患者持续戒烟。